SB858

SECTION 1. The legislature finds that during the coronavirus disease-19 (COVID-19) pandemic, many rural areas in the State of Hawaii were disconnected and unable to receive adequate healthcare services. As rural communities struggled with connectivity, transportation, and financial obligations, community health workers provided a critical lifeline to ensuring its residents healthcare needs are met. With the rapidly changing global health pandemic, rural communities that have limited healthcare services are at a greater risk of receiving access to adequate, timely and life-saving healthcare services.

Many families living in rural areas comprise diverse communities, including low‑income, underserved rural areas, all ethnicities, children, adults, families, elderly individuals, uninsured individuals, homeless individuals, immigrants and migrant workers. Many of these families face language and cultural barriers that require further assistance and technology in the community.

The legislature further finds that with deepening food insecurity, increasing housing instability, slow job recovery, and the replacement of many in-person health services with telehealth services, the need for community health workers to bridge communities and systems of care is greater than ever. Increasing the number of community healthcare workers and standardizing their certification and training will help address these issues.

The purpose of this Act is to:

(1) Establish a certification process, an oversight board, and a reimbursement process for services performed by community health workers to help address the social determinants of poor health that disproportionately affect low-income, minority populations and that are magnified during times of crisis; and

(2) Establish a task force to plan the certification and training process.

SECTION 2. The department of health shall establish a certification process for community health workers, including a retroactive certification process for established community health workers, oversight board, and reimbursement process for services provided by community health workers. The department of health shall consult with other departments, agencies, and community stakeholders for the establishment of the certification process, oversight board, and reimbursement process for service. In creating the certification process, the department of health shall consider:

(1) A certification process with at least two tiers of community health workers, which should be designated based on work and education experience;

(2) An oversight body to oversee community health workers and provide input to the legislature;

(3) A retroactive certification process for community health workers who have completed at least eighty hours of training and two thousand hours of experience prior to the establishment of a certification program; and

(4) Multiple sources of payment to community health workers.

SECTION 3. In developing competency standards for certification of community health workers, the department of health shall consider the following core competencies:

(1) Effective oral and written communication skills;

(2) Cultural familiarity and competency;

(3) Knowledge of local resources and health care system navigation;

(4) Advocacy and community capacity building skills;

(5) Care coordination skills;

(6) Ability to teach skills to promote healthy behavior change;

(7) Knowledge of outreach methods and strategies;

(8) Ability to address needs and identify resources;

(9) Understanding of public health concepts and health literacy;

(10) Understanding of ethics and confidentiality issues; and

(11) Ability to use and understand health information technology.

SECTION 4. (a) The department of health shall establish a community health worker certification task force to plan the certification and training process required by this Act.

(b) The following individuals shall serve as the members of the task force:

(1) The director of health or the director's designee, who shall serve as the chairperson of the task force;

(2) One community health worker from each county, to be designated by the director of health;

(3) A representative from the University of Hawaii system;

(4) A representative from the University of Hawaii office of public health studies;

(5) A representative from the Hawaii public health institute;

(6) A representative from the Hawaii public housing authority;

(7) A representative from the department of human services med-QUEST division;

(8) A representative from the Hawaii health systems corporation;

(9) A representative from the University of Hawaii west Oahu; and

(10) A representative from the University of Hawaii school of nursing and dental hygiene.

(c) The task force shall submit a report detailing the status of the certification and training process for community health workers required by this Act, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2022.

SECTION 5. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	858
THIRTY-FIRST LEGISLATURE, 2021
STATE OF HAWAII